Remote Nurse Case Manager II — Complex Care Leader

Elevance Health; Atlanta (GA); Hybrid; USD 80,000 - 105,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager II to manage care for members with complex and chronic needs. The role supports assessment, development, implementation, coordination, monitoring, and evaluation of care plans to optimize health outcomes.

This hybrid/virtual position emphasizes flexibility, with mandatory in-person training sessions and weekly onsite requirements as per policy. Requires RN licensure and a health-related BA/BS, with 5+ years of clinical experience; Case Manager

Qualifications

• Requires BA/BS in a health-related field.
• Minimum 5 years of clinical experience.
• Current, unrestricted RN license in applicable state.
• Case Manager certification preferred.

Responsibilities

• Assess and identify member needs and develop a specific care management plan.
• Coordinate, implement, monitor, and evaluate care plans to optimize member health across the continuum.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Facilitate authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Negotiate rates of reimbursement as applicable and support problem solving with providers.

Skills

RN license

Clinical experience

Case management experience

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager II to manage care for members with complex and chronic needs. The role supports assessment, development, implementation, coordination, monitoring, and evaluation of care plans to optimize health outcomes.

This hybrid/virtual position emphasizes flexibility, with mandatory in-person training sessions and weekly onsite requirements as per policy. Requires RN licensure and a health-related BA/BS, with 5+ years of clinical experience; Case Manager